PN Exit HESI Exit Exam

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Sample questions from PN Exit HESI Exit Exam

This material has 150 questions with answers and rationales. Here are the first 5.

1. 1.A client's potassium is 6.1 mEq/L (reference range 3.5 to 5.0 mEq/L). The client has chronic kidney disease and reports new muscle weakness. Which action should the practical nurse take first?

   • A.Administer the scheduled potassium supplement and recheck the level after the next meal.
   • B.Offer a potassium-rich snack because weakness can occur with inadequate dietary intake.
   • C.Encourage ambulation to reduce the effects of muscle weakness.
   • D.Obtain a current medication list and report the potassium result and weakness promptly to the RN.

   Rationale: The elevated potassium and new weakness in a client with kidney disease can signal a potentially dangerous electrolyte disturbance, so promptly reporting the findings is the safest action within PN scope. A medication review can help identify contributing drugs, but it does not replace reporting the critical result. Potassium supplementation and a potassium-rich snack could worsen hyperkalemia, while ambulation is not an appropriate response to new weakness before the cause is addressed.

2. 2.In the emergency department, a client with chronic obstructive pulmonary disease is receiving oxygen at 2 L/min by nasal cannula. The client is drowsier than at the previous check and has a respiratory rate of 10/min; SpO2 is 91%. Which action should the practical nurse take?

   • A.Stay with the client and promptly report the change in alertness and respiratory rate to the RN.
   • B.Remove the oxygen and reassess the client in 30 minutes.
   • C.Increase the oxygen flow until the SpO2 is at least 98%.
   • D.Encourage the client to walk to improve ventilation.

   Rationale: New drowsiness and a respiratory rate of 10/min are concerning changes that require prompt reporting and close observation, even though the SpO2 is 91%. Increasing oxygen to achieve 98% is not appropriate without an order and may not address hypoventilation. Removing prescribed oxygen or encouraging ambulation could worsen the client's condition and delay needed evaluation.

3. 3.During a home visit, a client who had a stroke 2 days ago is being prepared for lunch. Which actions should the practical nurse take to reduce aspiration risk while following the established care plan? Select all that apply.

   • A.Verify the prescribed food and liquid consistency before serving the meal.
   • B.Place food on the stronger side of the mouth if that technique is included in the established plan.
   • C.Leave the client alone once the meal tray is set up to promote independence.
   • D.Position the client upright for eating and keep the client upright after the meal as directed by the care plan.
   • E.Offer thin liquids through a straw to help the client swallow more quickly.
   • F.Offer small bites and allow time for the client to swallow before offering more food.

   Rationale: Verifying the ordered consistency, using upright positioning, pacing small bites, and following the established technique of placing food on the stronger side can reduce aspiration risk. Thin liquids and straws may be unsafe for a client with dysphagia unless specifically prescribed. The client should not be left alone during a meal when swallowing safety is a concern.

4. 4.Refer to the client's chart. Which finding requires the practical nurse to notify the RN immediately?

   • A.The client has a WBC count of 12,000/mm3, above the listed reference range.
   • B.The client has a blood pressure of 108/66 mm Hg and SpO2 of 95% on room air.
   • C.The temperature has risen to 38.6 C and the heart rate to 116/min, with a new decrease in urine output.
   • D.The client reports incisional pain of 5 on a 0-to-10 scale before a scheduled analgesic dose.

   Answer and rationale are in the full material.

5. 5.A client taking digoxin for heart failure reports nausea and seeing yellow halos. The apical pulse is 54/min before the scheduled dose. Which action should the practical nurse take?

   • A.Document the findings as expected effects of heart failure treatment.
   • B.Withhold the scheduled dose and promptly report the symptoms and pulse to the RN.
   • C.Ask the client to walk briefly, then administer the dose if the pulse increases.
   • D.Give the dose with food to reduce nausea, then reassess the pulse in 1 hour.

   Answer and rationale are in the full material.